Backup Documents 11/08/2022 Item #16C 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at
the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than
Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception
of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JJ I)11)
4. BCC Office Board of County
Commissioners 1e//t1 4ij/ /
5. Minutes and Records Clerk of Court's Office f
lets 2a- 11/
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff V Phone Number
Contact/ Department c mliV1 CvAar Z-59 262 .5317
Agenda Date Item was / p / 20 ZZ Agenda Item Number Approved by the BCC I C .
Type of Document Number of Original
Attached a C11, 0 rae,r Documents Attached
PO number or account Q.
number if document is 0 1197 L J
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature?
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed ZQi
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's Vfif"
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A"
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's AI/A
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on i/f 8/ZZ-and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County lei an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the ', an option for
Chairman's signature. this line.
1 6 C 4
MEMORANDUM
Date: November 16, 2022
Cc: Damian Cuadrado, Project Manager III
Collier County Wastewater
From: Martha Vergara, Sr. Deputy Clerk
Minutes & Records Department
Re: Change Order#1 for Contract #22-7950 for the "Pelican Bay
Blvd. Sewer Replacement"
Contractor: Quality Enterprises USA, Inc.
Attached is one (1) scanned copy of the original of the agreement as referenced above,
(Item #16C4) approved by the Board of County Commissioners on Tuesday,
November 8, 2022.
The original has been kept by the Board's Minutes and Records
Department as part of the Board's Official Records.
If you have any questions, please feel free to contact me at 252-7240.
Thank you.
Attachment
16C 4
Procurement Services
lel' County Change Order Form
®Contract Modification ❑Work Order Modification
Contract#: 22-7950 Change#: 1 Purchase Order#: 4500218365 Project#: 70240.1
Contractor/Firm Name: Quality Enterprises USA, Inc. Contract/Project: Pelican Bay Blvd Sewer Replacement
Project Manager Name: Damian Cuadrado Division Name: Engineering and Project Management
Original Contract/Work Order Amount $ 1,170,674.75 6/14/2022;11A Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 1,170,674.75' 6/14/2022;11A Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 1,170,674.75 12/29/2022 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total $ 1,170,674.75 0.00% Change from Current BCC Approved Amount
Cumulative Chan•es $ 0.00 0.00% Change from Current Amount
Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 8/1/2022 Original 12/29/2022 Last Approved 12/29/2022 Revised Date 2/24/2023
Date Completion Date Date Includes this change)
#of Days Added 57 Select Tasks 0 Add new task(s) ❑Delete task(s) ❑Change task(s) ® Other
Provide a response to the following: 1.)detailed and specific explanation/rationale of the requested change(s)to the task(s)and/or
the additional days added(if requested);2.)why this change was not included in the original contract;and,3.) describe the impact
if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed.
1. The purpose of this change order is to extend the time of the existing purchase order/contract by 57 days due to a
longer than expected wait for the ROW permit, delays in material delivery, and delays associated with Hurricane
Ian. The new Substantial Completion date will be January 25, 2023 and the new Final Completion date will be
February 24, 2023.
2. Work commencement was delayed for 49 days(starting on 9/19/22)due to waiting on ROW permit issuance and
delays in material delivery. Additionally, Hurricane Ian caused a further delay of 8 days.
3. If this change is not processed, the contractor may not be able to complete the work by the current Final
Completion date of 12/29/2022.
DoLitnan
CuadradoDamian „.., End
Prq•la.
Oil.E.Derr.anOMOoec tenctrryt 9w'.CN.CvabWq✓r4n.WOto.d,WPMl Utlr AncanN,
Prepared by: °""'D'101212°mod"n"'"�°�`�WD"�'.D��° """' Date:
Dax xm mu l�o1wam
(Damian Cuadrado, CSM Project Manager-PU Engineering and Project Management)
Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same
terms and conditions as contained in the contract/work order indicated above, as fully as if the same were stated in this acceptance.The
adjustment, if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/
Design Professional arising out of or related to the change set forth herein, including claims for impact and delay costs.
Accepted by: ) Date: 10/12/2022
(Lou Gaudio,Vice President—Quality Enterprises USA, Inc.)
Accepted by: N/A Date:
(Principal Project Manager—PU Engineering and Project Management)
Approved by: McLeanMatthew ;,;;;;,, ��.Ia�DD"«•a ��a-d �M Date:
(Matthew McLean, P.E.—Director—PU Engineering and Project Management)
Approved b : SChneebergerSara Digitally signed by:14:18 0400'5ara
pp y Date:2022.10.13 13:14:18-04'00' Date:
(Sarah Schneeberger, -Procurement Professional)
a) 10122022
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sh t) PROCUREMENT USE ONLY
Admin Rpi BCC ES
I
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel,Clerk of Courts COLLIER CO ' D A
&Comptroller `
(se) ikA
By: L � �_M.r. _ iffstrop'41 By: _;��•
Willi. . McDaniel,Jr., Chairman
Dated: k e .►i '�, . , /2Z
AL)Attesttaa to innan't'J
signature onty.
Appr ed as to f rm le lity:
By:
Scott R. Teach
Deputy County Attorney
cAo
16C 4
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive(-) Added Amount
The additional time is required to
1 Add 57 days NA NA 57 207 enable completion of construction
prior to contract expiration.
/ 10122022
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin Rpl BCC ES
JC1t•V